Breastfeeding and Birth Control

IUDs have no effect on breastfeeding, and are very effective. There is a possible risk of expulsion or uterine perforation if the device is not properly placed or is inserted before 6 weeks postpartum.

Permanent methods such as vasectomy and tubal ligation have no effect on breastfeeding and are nearly 100% effective. These methods are considered irreversible, and should only be considered if no more children are desired. If these methods are considered, counseling is recommended for couples. Vasectomy is considered minor surgery with minimal side effects. Tubal ligation may involve short-term mother-infant separation, and has risks, as all surgery does. Anesthesia may pass into breastmilk and sedate the baby. As a general rule, tubal ligation has more risks for the mother and is considered more complicated surgery than vasectomy is for the father.

The other non-hormonal method of birth control is natural family planning. This method involves learning the signs and symptoms of infertility, and may require extended periods of abstinence. It has no effect on breastfeeding, and can be very effective if used correctly. Because it may be difficult to interpret signs of fertility during breastfeeding, this method may require additional training in order to interpret the symptoms of fertility during lactation.

If the nursing mother chooses to use a hormonal method of birth control, the second choice is progestin only methods, such as Norplant (implants), mini-pills, or injectables (Depo-Provera). All of these methods can be very effective, and may even increase milk volume. Although some of the progestin hormone may enter the breastmilk, there is no evidence of adverse effects from the small amount of hormone that passes into the milk. It is recommended that the use of progestin-only hormones be delayed for at least six weeks post-partum due to the possibility of the hormones interfering with the early establishment of lactation.

The third and last choice of birth control for nursing mothers is methods which contain estrogen, such as the standard combined oral contraceptives. These methods are very effective, but often decrease milk supply, and some of the hormone may pass into the mother's milk. Although there is no evidence of a direct negative effect on the babies of mothers taking the combined pill, there is strong evidence that in many women, estrogen can lead to a decrease in milk supply and early weaning. If the other methods of birth control can't be avoided, and the combined pill is the only option, then breastfeeding can and should be continued, since it offers many health and nutritional benefits which are important for the nursing infant or toddler. If the mother chooses to use this method, the baby's weight should be monitored carefully so that adequate intake is ensured. For many mothers, a slight decrease in milk output is insignificant, and in any case, the benefits of breastfeeding far outweigh the disadvantages.

Anne Smith, IBCLC has breastfed a total of six children (three boys, three girls). She feels that her first hand experience plus her more than twenty years experience of counseling nursing mothers are among her most important credentials. Anne has been a La Leche Leader since 1978 and IBCLC since 1990. As a nursing mother, LLL Leader, and IBCLC, Anne has worked in many areas over the years. She has led support group meetings, taught breastfeeding classes, trained breastfeeding peer counselors to work with low income mothers, worked one-on-one with mothers to solve breastfeeding problems, helped thousands of mothers with breastfeeding questions over the phone, held workshops for health professionals on various breastfeeding topics, taught OB, Pediatric, and Family Practice Residents breastfeeding at Bowman Gray School of Medicine, and run a breast pump rental station with over 100 pumps, scales, and nursing bras for the past eleven years. We invite you to visit Anne's website.

Copyright © Anne Smith. Permission to republish granted to Pregnancy.org, LLC.

Comments

The information given at here about the Breastfeeding and Birth Control is really very good and we should think about this issue. There are number of different Birth Control Methods are now available for birth control. Many times the first choice of birth control for nursing mothers is non-hormonal methods. This includes condom use, which has the advantages of being readily available, and having no effect on breastfeeding. Condoms can be very effective if used correctly.